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NPI 1285456046

NPI 1285456046 : SENTINEL ANESTHESIA : REDDING, CA

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General NPI Number Information
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    NPI Number           |    1285456046
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    Entity Type          |    Organization 
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    Legal Business Name  |    SENTINEL ANESTHESIA 
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Dates
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    Enumeration Date     |    10/31/2024
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    Last Update Date     |    12/17/2025
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Provider Practice Location Address
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    Address Line         |    1100 BUTTE ST 
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    City                 |    REDDING
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    State                |    CA
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    Zip                  |    96001-0852
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    Country              |    US
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    Telephone            |    530-244-5400
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 7096 
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    City                 |    STOCKTON
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    State                |    CA
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    Zip                  |    95267-0096
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    Country              |    US
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    Telephone            |    209-956-7732
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     STACY  BAX 
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    Credential           |    MD
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    Telephone            |    209-956-7732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    
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    License Number State |    
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